Individual
ASIA JASMINE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5901 W OLYMPIC BLVD STE 401, LOS ANGELES, CA 90036-4669
(310) 651-9017
Mailing address
3514 7TH CT S APT 1, BIRMINGHAM, AL 35222-3239
(251) 597-5774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
56580
CA
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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